Autism, development delay often missed in Hispanics

by Karen Finney

(Medical Xpress)—Hispanic children often have undiagnosed developmental delays and large numbers of both Hispanic and non-Hispanic children who first were thought to have developmental delay actually had autism, researchers affiliated with the UC Davis MIND Institute have found.

The study, one of the largest to date to compare development in Hispanic and non-Hispanic children, is published in the journal Autism. The results lead the study authors to recommend increased public health efforts to improve awareness, especially among Hispanics, about the indicators of developmental delay and autism.

"Our study raises concerns about access to accurate, culturally relevant information regarding developmental milestones and the importance of early detection and treatment," said Virginia Chaidez, the lead author and a postdoctoral researcher in the UC Davis Department of Public Health Sciences when the study was conducted. "Autism and developmental delay tend to go undiagnosed when parents are not aware of the signs to look for, and the conditions are often misdiagnosed when parents don't have access to adequate developmental surveillance and screening."

Developmental delay is diagnosed in children who lag behind others in reaching important mental or physical milestones, while autism is characterized by deficits in social interactions and communication behaviors. The symptoms of both disorders can be improved with targeted interventions, with the greatest improvements seen when interventions begin early in life.

In conducting the study, the researchers used data from the Childhood Autism Risk from Genetics and the Environment (CHARGE) Study, a population-based study of factors that increase risk for autism or developmental delay. The current study included 1,061 children living in California who were between 24 and 60 months of age. They were divided into three groups: children with autism, children with developmental delay but not autism, and children with typical development. All diagnoses were confirmed or changed based on evaluations by MIND Institute clinicians.

The evaluations of Hispanic children were conducted by bicultural and bilingual clinicians in Spanish or English, depending on the primary language used at home. The results for children with at least one Hispanic parent of any race were compared to the results for children of non-Hispanic white parents.

"Our goal was to use the CHARGE Study to help fill the gaps in research on autism for Hispanics so we can better understand what autism is like for this growing U.S. population," said Irva Hertz-Picciotto, professor of public health sciences, researcher with the UC Davis MIND Institute and principal investigator of CHARGE. "No other study of autism has included such a large proportion of Hispanic children."

When the outcomes for Hispanic children were compared to non-Hispanic children, the results revealed more similarities than differences in terms of autism profiles, including diagnostic scores, language function, whether or not children lost acquired skills and overall intellectual, social and physical functioning.

A striking outcome, however, was that 6.3 percent of Hispanic children enrolled in the study who were selected randomly out of the general population met criteria for developmental delay, compared with only 2.4 percent of non-Hispanic participants, which is the expected percentage. This raised concerns among the researchers that many Hispanic children with developmental delays may not be getting the services they need.

For both Hispanic and non-Hispanic children, there was a high percentage (about 19 percent overall) of Hispanic and non-Hispanic children recruited for the study with developmental delay who actually met criteria for autism, raising concerns about adequate access to accurate developmental assessment.

When the analysis was restricted to bilingual children, a significant relationship also emerged between secondary language exposure (when a child was spoken to 25 to 50 percent of the time in a language other than English) and lower scores on standardized tests of receptive and expressive language. This resulted in lower overall cognitive scores for this group.

"Our results emphasize the importance of considering cultural and other family factors such as multiple language exposure that can affect development when interpreting clinical tests, even when they are conducted in the child's preferred language," said Robin Hansen, chief of developmental-behavioral pediatrics at UC Davis, director of clinical programs with the MIND Institute and a study co-author.

Hansen, the MIND Institute clinical team and the Center for Excellence in Developmental Disabilities at the MIND Institute have worked hard to provide accurate, current and evidence-based information about developmental disabilities to parents, educators, therapists and health-care specialists through an annual conference, website resources and community outreach.

"That so many children are slipping through the cracks is disheartening," Hansen said. "The differences between developmental disabilities can be subtle but important and involve distinct treatment pathways. We need to make sure that all children are getting routine developmental screening, early diagnosis and intervention so they can achieve their fullest potential."

For information on developmental milestones, visit the Centers for Disease Control and Prevention "Learn the Signs" website, which is available in English and Spanish at www.cdc.gov/ncbddd/actearly/index.html. Parents with concerns about their child's development should work with their health-care provider, school district and California Department of Developmental Services regional center to identify appropriate services.

Related Stories

(HealthDay) -- Six longitudinal developmental trajectories have been identified among children with autism, with significant heterogeneity seen in developmental pathways within these trajectories, according ...

The first prospective study of ethnic differences in the symptoms of autism in toddlers shows that children from a minority background have more delayed language, communication and gross motor skills than Caucasian children ...

A team of UC Davis researchers has found that mothers who had fevers during their pregnancies were more than twice as likely to have a child with autism or developmental delay than were mothers of typically developing children, ...

The Centers for Disease Control has launched its second phase of a multistate study on autism and JFK Partners at the University of Colorado School of Medicine, the Colorado School of Public Health and the Colorado Department ...

A new University of Miami (UM) study shows that one in three children who have an older sibling with an Autism Related Disorder (ASD) fall into a group characterized by higher levels of autism-related behaviors or lower levels ...

Recommended for you

The communication struggles of children with autism spectrum disorder can drive parents and educators to try anything to understand their thoughts, needs and wants. Unfortunately, specialists in psychology ...

Technology is often maligned for having a negative influence on young people, particularly on their ability to develop healthy social relations and a sense of identity. But technology can also be a force for good. ...

While aggression toward caregivers and peers is a challenge faced by many individuals and families dealing with autism, there has been much speculation in the media over the possibility of generally heightened aggression ...

(Medical Xpress)—A pair of researchers with Emory University in Atlanta has published a Perspective piece in the journal Science, questioning whether oxytocin can help people with an autism spectrum disord ...

A growth hormone can significantly improve the social impairment associated with autism spectrum disorder (ASD) in patients with a related genetic syndrome, according to a pilot study conducted at the Icahn ...

User comments

Please sign in to add a comment.
Registration is free, and takes less than a minute.
Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.